Endoscopic surgery is often used to perform prostate, intra-uterine, bladder and urinary track surgery. The most common method of performing prostate surgery is to resect the enlarged prostate gland with an electrosurgical loop inserted into the urethra through an endoscope. The electrosurgical device shaves off small pieces of prostate tissue in order to enlarge the passageway, thereby providing the patient with relief. A problem with this method of surgery is that substantial bleeding occurs as the prostate tissue is being cut, making visibility through the endoscope difficult. Blood loss also complicates the surgical operation and lengthens the hospital stay. Additionally, this method of surgery is difficult to perform making extensive training necessary. Finally, the procedure is lengthy, taking up to 11/2 hours to perform.
Another method of performing prostate surgery is to insert an optical fiber which is optically coupled to a laser into the prostate gland through an endoscope. The laser energy conveyed by the optical fiber coagulates or cooks surrounding prostate gland tissue. In some instances, it is desirable for the optical fiber to include a tip which directs the laser energy laterally in order to make the procedure easier to perform. The coagulated tissue remains in place for about four to six weeks before the coagulated tissue falls off and is passed during urination. Therefore, the patient must endure a long period of discomfort and may need a catheter for passage of urine until the coagulated tissue is finally passed.
An attempt to alleviate the problems of both procedures is disclosed in U.S. Pat. No. 5,011,483, issued to Sleister, where a laser/electrosurgical instrument provides laser energy for coagulating tissue and an electrosurgical loop for cutting the coagulated tissue. The coagulation of the tissue prevents bleeding when the tissue is cut away.